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CHAPTER 51 – Pisohamate Ligament Instability/Tear

Jacinto Orozco, MD,
Ghazi M. Rayan, MD


Pisiform ligament complex syndrome (PLCS) is peri-pisiform ulnar palmar wrist pain caused by injury or disease to the components of the pisiform ligament complex (PLC). The PLC consists of the pisiform bone, pisiform ligaments, and the flexor carpi ulnaris (FCU) tendon. Injury to the pisiform ligaments leads to varying degrees of pisotriquetral (PT) joint instability with subsequent arthrosis. Osteoarthrosis (OA) of the PT joint is a degenerative joint disease involving the articular surfaces of the pisiform and triquetrum. Primary OA of the PT joint is an uncommon disorder. Many arthritic disorders of this joint are post-traumatic in nature preceded by PT joint instability. Familiarity with the anatomy and biomechanics of the pisiform and PT joint ligaments is crucial for understanding its pathologic disorders.